Birthmarks in Infants and Children

About 1% of newborns are born with congenital nevi or moles. These are brown or black in color and may be raised or flat with the skin. They grow with the child and are safe if less than 2-3 inches in size.  Children can also develop acquired nevi or moles following delivery. These are common in Caucasians who have an average of 10-30 pigmented nevi or moles. They often develop after age 5 years.  Warning signs for neoplastic changes include asymmetry, border irregularity and color change. If a nevi or mole “looks different” from neighbor nevi it needs to be evaluated by a doctor.

Sun freckles are common and increase with sun exposure. These dark spots are flat and run in families. They are more prominent in the summer. If your child is prone to freckles then sun protection is a must. Children with fair skin are prone to freckles as well as having an increased risk for skin damage due to unprotected sun exposure and have an increased risk of skin cancer and malignant melanoma.

Hemangiomas are raised red or reddish blue bumps. They are caused by the growth of blood vessels that cause an abnormal amount of blood vessels to grow. They are seen in 2% of infants and often develop after 1-2 months of age. Treatment usually is not needed but depends on size, rate of growth and location. Locations around the mouth, eye, and nose and in the throat raise concern for treatment. If multiple hemangiomas are present then there are concerns about internal hemangiomas on various body organs.

Flat angiomata are called “stork bites or angel kisses”. They are seen on the face an on the nape of the neck. They become more visible when an infant cries or becomes hot. No treatment is needed. They usually fade by school age.

Port wine stains are rare and often indicate an underlying medical condition. This type of birthmark can be seen on the face and limbs. They are large in size and dark red to purple in color. They are not raised.

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